Remote Clinical Documentation Improvement program helps keep medical records accurate

Advantasure^® employs the Remote Clinical Documentation Improvement program to help providers accurately capture their patients’ severity of illness in their medical records.

The Centers for Medicare & Medicaid Services requires providers to document certain chronic conditions in the patient’s medical record at least once every calendar year.

The incentive-based Remote CDI program uses the Clinical Documentation Improvement Alert, a single-page guide to help providers perform CMS-compliant medical record documentation during face-to-face, audio and audiovisual telehealth visits. Advantasure will distribute CDI Alerts to providers up to three times a year that are based on:

• Actual diagnoses submitted on claims within the prior two calendar years
• Potential new diagnoses based on findings in the medical record or prior pharmacy and lab claims
• Star Ratings or quality measure gaps identified through claims data that may require tests or services to be ordered for your patient

How to earn the Remote CDI incentive

• Address all identified confirmation of diagnosisand clinical documentation improvement opportunities on your patients’ CDI Alerts by Dec. 31 each calendar year.
• Submit a completed CDI Alert with the office visit notes from the same date of service. (Healthy Blue portal closures do not qualify for the Remote CDI incentive.)
• Submit the alerts to Advantasure within 14 days of the patient visit.

Providers who close out 100% of the identified risk gaps listed on the CDI Alert are eligible to earn a $100 incentive for each attributed member.

For more information about the program or to request a brochure, contact:

• Tom Rybarczyk, clinical consultant, at 313-378-8259
• Denise McMillan, senior analyst, at 313-407-7529

Blue Cross has partnered with Advantasure on the Remote Clinical Documentation Improvement program. This program supports providers in accurately addressing conditions for their Medicare Advantage patients.